Aims: To evaluate the patterns of overall survival (OS) and recurrence following surgical resection of colorectal liver metastases (CRLM).
Methods: In compliance with STROCSS guideline, a single-centre retrospective cohort study was conducted. All consecutive patients undergoing resection of CRLM between 2003 and 2019 were considered eligible for inclusion. The outcome measures included OS, recurrence-free survival (RFS), recurrence rate, time to recurrence (TTR) and longest TTR. Statistical analyses included simple descriptive statistics and Kaplan-Meier survival statistics.
Results: We included 486 liver resections in 472 patients. The estimated median OS and RFS were 5.1 years and 3.1 years, respectively. The probability of 1-year, 3-year, 5-year and 10-year OS was 93%, 69%, 50% and 34%, respectively. The probability of 1-year, 3-year, 5-year and 10-year RFS was 81%, 50%, 34% and 33%, respectively. Recurrence occurred in 56% (271/486) of patients, and the median TTR was 1.6 years (IQR: 0.8-2.7) with longest TTR of 4.8 years. Although there were no recurrences in the 66 patients that entered the 6th year, the 95% CI for true rate of recurrence in the population given these data is 0-5.4%.
Conclusions: Our results suggest that recurrences that occur after operative management of CRLM are almost certain to occur within the first 5 years even for patients surviving longer than 5 years. This does not disprove the requirement for follow up beyond 5 years. However, based on this data, we have altered our follow up from 10 to 6 years. The need for the 6th year of follow up will be reassessed in light of further observations.
Keywords: Colorectal cancer; Colorectal liver metastases; Liver resection; Survival.
© 2022. Crown.